Current opinion in pediatrics最新文献_第3页

The globalization of cystic fibrosis care.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-03-27 DOI: 10.1097/MOP.0000000000001458

Carlos E Milla

{"title":"The globalization of cystic fibrosis care.","authors":"Carlos E Milla","doi":"10.1097/MOP.0000000000001458","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001458","url":null,"abstract":"Purpose of review: The field of cystic fibrosis is experiencing dramatic changes, as the translation of a massive body of scientific knowledge accumulated from the day of the cloning of the CFTR gene has led to the identification of effective therapies to correct the basic defect. This has also allowed care providers and people with cystic fibrosis in low-income and middle-income countries (LMICs) to become more knowledgeable and proficient in cystic fibrosis cares.Recent findings: This review focuses on two main aspects highly relevant to understand the current status of cystic fibrosis in LMICs: The recognition of the universal occurrence of cystic fibrosis, as well as the varying incidence in different regions of the world, and the collaborative international efforts for dissemination of best care practices as an attempt to close gaps in care.Summary: As the field continues to change rapidly, multiple international efforts are attempting to close gaps and disparities clearly apparent between affluent countries and LMICs. However, these efforts are seriously hampered by limited access to effective therapies and most dramatically to CFTR modulator drugs.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Recent updates on the screening, diagnosis, and management of lipids disorders in children and adolescents.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-03-27 DOI: 10.1097/MOP.0000000000001460

Meghan Sara Drastal, Sarah de Ferranti, Holly Gooding

{"title":"Recent updates on the screening, diagnosis, and management of lipids disorders in children and adolescents.","authors":"Meghan Sara Drastal, Sarah de Ferranti, Holly Gooding","doi":"10.1097/MOP.0000000000001460","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001460","url":null,"abstract":"Purpose of review: The purpose of this review is to provide an update on screening, diagnosis, and treatment of lipid disorders in the pediatric patient.Recent findings: Apart from the United States Preventive Services Task Force (USPSTF), the majority of medical societies recommend universal screening for lipid disorders in children and adolescents 21 years or younger. Recent population studies confirm lipid abnormalities are prevalent in children, affecting at least one in five children aged 6-19 years. A systematic review and network meta-analysis of lipid-lowering therapies in children and adolescents with familial hypercholesterolemia found that statins reduced LDL-C by 33.61% and adding ezetimibe reduced LDL-C by an additional 15.85%.Summary: Nearly all major medical societies recommend universal lipid screening in children aged 9-11 and 17-21. Lipid abnormalities are common, and diagnosis is generally made by confirming abnormal lipid results with fasting lipid studies. Lifestyle modifications and statins are the mainstay for treatment of dyslipidemia. However, most research on lipid-lowering therapies is in familial hypercholesterolemia.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Who may compete in the female category in sport? Chromosomes, genes, hormones, and psychosocial/cultural aspects.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-03-21 DOI: 10.1097/MOP.0000000000001456

Natalie J Nokoff, Alan D Rogol

{"title":"Who may compete in the female category in sport? Chromosomes, genes, hormones, and psychosocial/cultural aspects.","authors":"Natalie J Nokoff, Alan D Rogol","doi":"10.1097/MOP.0000000000001456","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001456","url":null,"abstract":"Purpose of review: Throughout history, competitive sport has been categorized by sex. Since the 1930s, sporting organizations have implemented various methods of confirming sex for competition in the female category. These policies primarily impact individuals with differences of sex development (DSD), whose biology falls outside the binary of male/female, and individuals who identify as transgender, whose identity differs from their sex at birth. This review will cover the dimensions of biologic sex, the history of sex verification in sport, the role of testosterone, and review data for athletes who have a DSD or are transgender.Recent findings: Several recent studies, reviews, and policy statements demonstrate that testosterone and its rise during masculinizing puberty are key determinants of differences in athletic performance between men and women. Recent studies in adult transgender women who went through a masculinizing puberty show that after 2 years of estradiol and antiandrogen therapy, run times are similar to cisgender women, but they still retrain strength advantages. Data are sparse for individuals who had masculinizing puberty blocked and also for individuals who have a DSD.Summary: Sex is complex and multidimensional, and there are shortcomings with any method of sex verification in sport. Testosterone remains a key determinant of differences in athletic performance by sex.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143763410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

IUDs and pain control for adolescents and young adults. 宫内节育器和青少年疼痛控制。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-03-20 DOI: 10.1097/MOP.0000000000001457

Sydney M Hartman-Munick, Grace Jhe, Anne Powell

引用次数: 0

Current scope of pediatric trauma video review and development of a Canadian program.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-03-19 DOI: 10.1097/MOP.0000000000001454

Suzanne Beno, Caitlin Ross, Melissa Lorenzo

{"title":"Current scope of pediatric trauma video review and development of a Canadian program.","authors":"Suzanne Beno, Caitlin Ross, Melissa Lorenzo","doi":"10.1097/MOP.0000000000001454","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001454","url":null,"abstract":"Purpose of review: Trauma video review (TVR) programs have become an essential component of trauma performance improvement programs, providing a novel lens on real-time clinical data driving education, research, and quality improvement (QI) in trauma resuscitations. This review aims to explore the current scope of TVR in pediatric trauma. We also describe the implementation and QI impact of the first pediatric TVR program in Canada, at The Hospital for Sick Children (SickKids) in Toronto, Ontario.Recent findings: TVR has demonstrated the ability to identify latent safety threats, improve adherence to advanced trauma life support (ATLS) and trauma checklists, and optimize critical interventions such as vascular access and intubation. Its use has revealed significant variability in team performance, time-based metric goals, and communication, enabling targeted QI initiatives. For example, structured prehospital to trauma team handover protocols and tools like T-NOTECHS have enhanced communication and teamwork in trauma resuscitations. Despite concerns around medicolegal risks and staff anxiety, TVR has been favorably received, with notable benefits outweighing potential drawbacks.Summary: TVR is emerging as a critical tool in pediatric trauma care, already demonstrating transformative QI integrated into existing performance improvement programs. Pediatric trauma programs should consider implementation within their local context.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Respiratory syncytial virus vaccination: likely and less likely outcomes.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-03-19 DOI: 10.1097/MOP.0000000000001455

Dvir Gatt, Guy Hazan

{"title":"Respiratory syncytial virus vaccination: likely and less likely outcomes.","authors":"Dvir Gatt, Guy Hazan","doi":"10.1097/MOP.0000000000001455","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001455","url":null,"abstract":"Purpose of review: Respiratory syncytial virus (RSV) remains a leading cause of lower respiratory tract infections in infants, older adults, and high-risk populations. The recent approval of new RSV vaccines and monoclonal antibodies marks a turning point in RSV prevention. This review explores these advancements, their immediate and potential long-term effects, and the remaining challenges.Recent findings: Several novel RSV prevention strategies have been approved, including maternal RSVPreF vaccines, infant-targeted monoclonal antibodies like Nirsevimab, and vaccines for older adults. These interventions significantly reduce RSV-related hospitalizations, ICU admissions, and mortality, particularly in high-risk groups. Early evidence also suggests benefits in reducing wheezing during infancy; however, long-term impacts on asthma development remain uncertain. Challenges such as vaccine hesitancy and limited access in low-resource settings remain pressing issues that require sustained focus.Summary: RSV vaccines and monoclonal antibodies are expected to alter clinical management and public health by reducing severe disease burden and RSV transmission. Further research is needed to evaluate their long-term effects, including implications for asthma prevention and pediatric obstructive sleep apnea. Addressing access disparities and public acceptance will be critical for maximizing their global impact.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artificial intelligence impacts in education and pediatric mental health.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-03-19 DOI: 10.1097/MOP.0000000000001453

Grace Liberatore, Alyssa Kim, Jack Brenner, Ruth Milanaik

{"title":"Artificial intelligence impacts in education and pediatric mental health.","authors":"Grace Liberatore, Alyssa Kim, Jack Brenner, Ruth Milanaik","doi":"10.1097/MOP.0000000000001453","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001453","url":null,"abstract":"Purpose of review: Increased accessibility of artificial intelligence to children has raised concerns regarding its effects on education and student mental health. Pediatricians should continue to be informed about the effects of artificial intelligence in their patients' daily lives, as artificial intelligence is becoming increasingly present.Recent findings: The use of artificial intelligence to create personalized study material illustrates a benefit of incorporating this technology into education. However, an overreliance on artificial intelligence could decrease students' problem-solving skills and increase plagiarism. Novel uses of artificial intelligence have also raised concerns regarding mental health. Deepfake technology, which utilizes artificial intelligence to create images, videos, and/or audio that appears real but is fabricated, can be viewed online by children, which could have negative mental health implications.Summary: Although artificial intelligence has the potential to revolutionize education at all levels, its use as an enhancement, not replacement, to current educational strategies is imperative. Both parents and students need to understand the limitations of artificial intelligence in education, and simultaneously prioritize developing the necessary cognitive skills strengthened throughout education. Pediatricians and parents should also be aware of the potentially dangerous material generated by artificial intelligence that can negatively impact children's mental health.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Precision decisions in pediatric airway management: addressing physiologic difficulty.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-03-10 DOI: 10.1097/MOP.0000000000001450

Laura Wylie, Kelsey A Miller, Joshua Nagler

{"title":"Precision decisions in pediatric airway management: addressing physiologic difficulty.","authors":"Laura Wylie, Kelsey A Miller, Joshua Nagler","doi":"10.1097/MOP.0000000000001450","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001450","url":null,"abstract":"Purpose of review: Precision medicine is based on the idea that treatment can be individualized for each patient in a given clinical environment. This review summarizes factors that should be considered when clinicians are creating individualized plans for intubation, specifically focusing on physiologically difficult airways. Recent literature identifying physiologic risk factors is summarized, and individual and system-level interventions that can potentially mitigate risk are reviewed.Recent findings: Physiologic derangements, most notably hypoxia and hypotension, have been associated with increased incidence of severe adverse events during intubation attempts. Individualized peri-procedural efforts to improve physiologic parameters through optimal oxygen delivery, fluid resuscitation, vasopressor administration, and thoughtful choice in rapid sequence intubation (RSI) medications may improve patient outcomes. Systems of care are being built around airway bundles, cognitive aids, and collaborations with airway teams to optimize outcomes.Summary: Providers should develop individualized care plans for their patients to optimize physiologic and anatomic parameters peri-intubation. The physiologically difficult airway affects the rate of first pass success and adverse events, therefore patients should be optimized prior to undergoing the procedure based on their clinical presentation and data.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Environmental factors trigger pubertal development. 环境因素引发青春期发育。

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-02-28 DOI: 10.1097/MOP.0000000000001451

Sofia Malave-Ortiz, Cameron Grant, Natalie D Shaw

引用次数: 0

Update on neonatal and infantile onset epilepsies.

IF 2.2 3区医学

Current opinion in pediatrics Pub Date : 2025-02-11 DOI: 10.1097/MOP.0000000000001448

Evelina Carapancea, Tristan T Sands, Maria Roberta Cilio

{"title":"Update on neonatal and infantile onset epilepsies.","authors":"Evelina Carapancea, Tristan T Sands, Maria Roberta Cilio","doi":"10.1097/MOP.0000000000001448","DOIUrl":"https://doi.org/10.1097/MOP.0000000000001448","url":null,"abstract":"Purpose of review: Neonatal and infantile epilepsies represent a diverse group of disorders with significant neurodevelopmental impact, necessitating early diagnosis, and tailored treatment. Recent advancements in genetic research, phenotyping, and therapeutic development have reshaped the understanding and management of these conditions, making this review both timely and relevant.Recent findings: Next-generation sequencing has emerged as a cornerstone for diagnosing neonatal and infantile epilepsies, offering high diagnostic yields and enabling identification of etiology-specific phenotypes. Precision therapies, including sodium channel blockers, ganaxolone, and mammalian target of rapamycin (mTOR) inhibitors, target specific molecular mechanisms. Early initiation of treatment in conditions with a high risk of progressing to epilepsy, like vigabatrin in tuberous sclerosis complex, lower the incidence of infantile spasms and improve developmental outcomes. Drug repurposing has also provided effective options, such as fenfluramine in Dravet syndrome, with promising outcomes. Gene-based therapies, including antisense oligonucleotides and gene replacement, represent the new frontier for addressing the root causes of these disorders.Summary: The integration of genetic and molecular advancements is transforming the management of neonatal and infantile epilepsies, fostering precision-driven care. Continued research and innovation are essential to refine these strategies, optimize patient outcomes, and establish new standards of care.","PeriodicalId":10985,"journal":{"name":"Current opinion in pediatrics","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143389982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0